<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Username')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-userName" data-rule="required" class="form-control" name="row[userName]" type="text" value="{$row.userName|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Openid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-openid"  class="form-control" name="row[openid]" type="text" value="{$row.openid|htmlentities}">
        </div>
    </div>
  
        <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">保险公司:</label>
        <div class="col-xs-12 col-sm-8">
            <select  id="c-insurance_company" class="form-control"   name="row[insurance_company]">
            
                <option value="PINGAN" {if $row.insurance_company eq 'PINGAN'}selected{/if}>中国平安保险</option>
                <option value="PICC" {if $row.insurance_company eq 'PICC'}selected{/if}>中国人民财产保险</option>
                 
            </select> 
        </div>
    </div>
   <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">电子邮箱:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-email" data-rule="required" class="form-control" name="row[email]" type="text" value="{$row.email|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Safe_years')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-safe_years" data-rule="required" class="form-control" name="row[safe_years]" type="text" value="{$row.safe_years|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Big_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-big_number" data-rule="required" class="form-control" name="row[big_number]" type="text" value="{$row.big_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Small_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-small_number" data-rule="required" class="form-control" name="row[small_number]" type="text" value="{$row.small_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Fee')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-fee"  class="form-control" name="row[fee]" type="text" value="{$row.fee|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Invite_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-invite_name"  class="form-control" name="row[invite_name]" type="text" value="{$row.invite_name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Car_style')}:</label>
        <div class="col-xs-12 col-sm-8">

<div class="radio">
    <label for="row[car_style]-normal"><input id="row[car_style]-normal" checked="checked" name="row[car_style]" type="radio" {if $row.car_style eq '新车'}checked{/if}  value="新车"> 新车</label> 
    <label for="row[car_style]-hidden"><input id="row[car_style]-hidden" name="row[car_style]" type="radio" {if $row.car_style eq '二手车'}checked{/if} value="二手车"> 二手车</label>

</div> 
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Real_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-real_name" data-rule="required" class="form-control" name="row[real_name]" type="text" value="{$row.real_name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Card_no')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-card_no" data-rule="required" class="form-control" name="row[card_no]" type="text" value="{$row.card_no|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Tel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-tel" data-rule="required" class="form-control" name="row[tel]" type="text" value="{$row.tel|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-address"  class="form-control" name="row[address]" type="text" value="{$row.address|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Car_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-car_number" class="form-control" name="row[car_number]" type="text" value="{$row.car_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Vehicle_model')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-vehicle_model"  class="form-control" name="row[vehicle_model]" type="text" value="{$row.vehicle_model|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Car_no')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-car_no" class="form-control" name="row[car_no]" type="text" value="{$row.car_no|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Engine_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-engine_number" class="form-control" name="row[engine_number]" type="text" value="{$row.engine_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Frame_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-frame_number" data-rule="required" class="form-control" name="row[frame_number]" type="text" value="{$row.frame_number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Dj_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-dj_time"  class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[dj_time]" type="text" value="{:$row.dj_time?datetime($row.dj_time):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Buy_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-buy_time"  class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[buy_time]" type="text" value="{:$row.buy_time?datetime($row.buy_time):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Az_address')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-az_address" class="form-control" name="row[az_address]" type="text" value="{$row.az_address|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Az_user')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-az_user"  class="form-control" name="row[az_user]" type="text" value="{$row.az_user|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Device_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-device_id" data-rule="required" data-source="device/index" class="form-control" name="row[device_id]" type="text" value="{$row.device_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Car_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-car_price" class="form-control" name="row[car_price]" type="text" value="{$row.car_price|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Dk_prrice')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-dk_prrice"  class="form-control" name="row[dk_prrice]" type="text" value="{$row.dk_prrice|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Beneficiary')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-beneficiary" data-rule="required" class="form-control" name="row[beneficiary]" type="text" value="{$row.beneficiary|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Create_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-create_time"  class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[create_time]" type="text" value="{:$row.create_time?datetime($row.create_time):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Out_trade_no')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-out_trade_no"  class="form-control" name="row[out_trade_no]" type="text" value="{$row.out_trade_no|htmlentities}">
        </div>
    </div>
     <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">备注:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-remark"  class="form-control" name="row[remark]" type="text" value="{$row.remark|htmlentities}">
        </div>
    </div>
    <div class="form-group" style="display: none;">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pay_status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pay_status"  class="form-control" name="row[pay_status]" type="number" value="{$row.pay_status|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pay_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pay_time"  class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[pay_time]" type="text" value="{:$row.pay_time?datetime($row.pay_time):''}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
